Physical Activity Programme and Review, Essay Example

Reviews of Cardiac Rehabilitation

Cardiac rehabilitation is a vital process for the recovery of patients who have suffered one or more forms of heart conditions. While this process does not change a patient’s history, it can be vital in helping and improving the patient’s future. This process entails a medically supervised program that is configured to help improve the cardiovascular health of a patient who has experienced heart failure, a heart attack, or has undergone heart surgery (American Heart Association, 2019).

While the prevalence of atherosclerotic cardiovascular disease (ASCVD) continues to increase annually, the most effective strategies in managing and recovering from this condition have employed a multidisciplinary approach (Sandesara, et al., 2015). Such a program is designed to not only mitigate the risk associated with heart conditions.

The benefits associated with the use of a cardiac rehabilitation program have been documented by numerous studies (Dibben, et al., 2018; Nilsson, Lunde, Grøgaard, & Holm, 2018). The use of a cardiovascular rehabilitation program that is exercise-based is a common strategy employed that has been found to lead to a reduction in mortality as well as reducing the risk of hospital readmissions (Sumner, Harrison, & Doherty, 2017). Additionally, the use of a cardiovascular rehabilitation program has been found to improve the overall health-related quality of life in one or multiple domains (Anderson, et al., 2016). However, the adoption rate of these programs is met with a number of significant barriers. The majority of these barriers are either based on cost or patient perception of the importance and value of the rehabilitation program.

Needs Analysis for Smith

To ascertain the scope and depth of the activities that should be entailed in Smith’s cardiac rehabilitation, there’s a need to determine the needs that define his case (Smith, Garton-Smith, Briffa, & Maiorana, 2015). The Cardiac Rehabilitation Needs Assessment Tool by the Heart Online (Heart Online, 2014).

The results of the needs analysis showed that Smith had already conducted some research on his heart condition and he possesses written information about his heart condition. He is well aware of what to do the event he experiences angina, i.e., a heaviness in the chest or chest pains. He is also up-to-date with his medication list while remaining aware an up-to-date with his cardiology follow up plan. He also has regularly scheduled visits to his GP on a fortnight basis. Having been referred by his GP, he is interested in receiving support on exercise, weight loss and diet, sleep issues, smoking, cholesterol, controlling moods and emotion and managing blood pressure. Smith’s main preference for cardiac rehabilitation is a location that is close to his workplace and fits into his working hour routine. Smith has one major concern in the form of depression as he has recently experienced symptoms of depression which he is worried may be connected to his heart condition.

It is plausible that the symptoms of depression described by Smith are linked to his heart condition. The relationship between depression and heart disease is cyclical in nature where one fuels the other (Celano, Villegas, Albanese, Gaggin, & Huffman, 2018). Being diagnosed with heart disease can increase one’s predisposition to depression (Dhar & Barton, 2016). However, depression itself can cause adverse cardiac events (Celano, Villegas, Albanese, Gaggin, & Huffman, 2018). One of the definitive characteristics and symptoms of depression is a reduction in physical activity. Individuals who suffer from depression find it difficult to gather the will and desire to engage in physical activity. On the other hand, the reduction in physical activity increases the likelihood of weight gain, increased cholesterol levels, all of which increase an individual’s risk of developing heart disease or experiencing an adverse cardiac event (Dhar & Barton, 2016). Having experienced symptoms of depression, the most common psychiatric disorders globally, Smith may significantly benefit from a regime of physical exercise (Blake, 2012).

The majority of the causes of heart disease can be attributed to behavioral-based factors, where an individual’s behavior directly affects their health and predisposition to heart conditions. While pharmacological treatment is the most and mainly employed method of rehabilitation, behavioral-based intervention, such as exercise and diet, play a vital role in mitigating or eliminating the risk factors associated with heart failure. As such, the proposed program employs a behavioral-based approach, targeting to help Smith adopt positive behaviors that will aid in his recovery.

Physical Activity Programming for Special Populations

Rationale

The design of the program and gym session has taken into consideration a number of factors that are vital to Smith’s recovery. First, medication is key to the recovery process. While most medications prescribed for Smith have a specific dosage and times schedule, they tend to have a significant impact on Smith’s physical activity.

The most vital factor in developing an ideal and patient-centered cardiovascular rehabilitation plan is the severity of Smith’s heart condition. Taking into consideration Smith’s cardiac event took place within a few weeks of engaging the cardiac rehabilitation plan, the intensity of the exercises has been set to progressively increase with his ability to undertake the more strenuous activity (Dibben, et al., 2018). As such, Smith’s blood pressure is a vital metric before, during, and after performing each exercise, as well as each session. This shall be tracked using a digital blood pressure monitoring device.

Smith’s fitness levels are vital to developing a program that is best suited to his recovery. While the main aim of the program is to improve Smith’s general fitness levels, the expectations for growth have to be curtailed by the potential limitations that he can achieve in his current health and physical state (Nilsson, Lunde, Grøgaard, & Holm, 2018). As such, the types of activities and their respective levels of intensity have been tailored to match Smith’s current fitness level. Smith is set to begin at the lowest level, performing simple exercises at home with the main aim of increasing his ability to climb the stairs. The aerobic and resistance training is also set to progressively increase as Smith gains more control and capacity for strenuous activity.

One significant limitation has been placed on Smith’s cardiac rehabilitation program, i.e., the intensity of exercise is limited to moderate until the final two weeks of the 12-week program. This is a vital safety precaution that has been designed to ensure Smith’s progression is gradual, measured and monitored (Smith, Garton-Smith, Briffa, & Maiorana, 2015). This also takes into consideration the potential risk of Smith suffering and cardiac event during strenuous activities. Additionally, the program has been set up to allow for optimal adherence by Smith. It takes into consideration Smith’s work schedule and allows for access to vital resources, such as the gym, weights, and instructor.

References

American Heart Association. (2019, February). What is Cardiac Rehabilitation? Retrieved April 18, 2019, from Heart.org: https://www.heart.org/en/health-topics/cardiac-rehab/what-is-cardiac-rehabilitation

Anderson, L., Oldridge, N., Thompson, D. R., Zwisler, A.-D., Rees, K., Martin, N., & Taylor, R. S. (2016, January). Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease. Journal of the American College of Cardiology, 67(1), 1-12 DOI: 10.1016/j.jacc.2015.10.044.

Blake, H. (2012). Physical activity and exercise in the treatment of depression. Frontiers in Psychiatry, 3, 106 DOI: 10.3389/fpsyt.2012.00106.

Celano, C., Villegas, A. C., Albanese, A. M., Gaggin, H. K., & Huffman, J. C. (2018). Depression and Anxiety in Heart Failure: A Review. Harvard Review of Psychiatry, 26(4), 175–184 DOi: 10.1097/HRP.0000000000000162.

Dhar, A. K., & Barton, D. A. (2016, March). Depression and the Link with Cardiovascular Disease. Frontiers in Psychiatry, 7(33), DOI: 10.3389/fpsyt.2016.00033.

Dibben, G. O., Dalal, H. M., Taylor, R. S., Doherty, P., Tang, L. H., & Hillsdon, M. (2018). Cardiac rehabilitation and physical activity: systematic review and meta-analysis. Heart, 104(17), 1394-1402 DOI: 10.1136/heartjnl-2017-312832.

Heart Online. (2014, November). Cardiac Rehabilitation Needs Assessment Tool. Retrieved April 18, 2019, from http://www.heartonline.org.au/media/DRL/Cardiac_rehabilitation_needs_assessment_tool.pdf

Nilsson, B. B., Lunde, P., Grøgaard, H. K., & Holm, I. (2018). Long-Term Results of High-Intensity Exercise-Based Cardiac Rehabilitation in Revascularized Patients for Symptomatic Coronary Artery Disease. American journal of cardiology, 121(1), 21-26 DOI: 10.1016/j.amjcard.2017.09.011.

Sandesara, P. B., Lambert, C. T., Gordon, N. F., Fletcher, G. F., Franklin, B. A., Wenger, N. K., & Sperling, L. (2015, February). Cardiac Rehabilitation and Risk Reduction: Time to “Rebrand and Reinvigorate”. Journal of the American College of Cardiology, 65(4), 389-95 DOI: 10.1016/j.jacc.2014.10.059.

Smith, J., Garton-Smith, J., Briffa, T., & Maiorana, A. (2015, May). The development of a new cardiac rehabilitation needs assessment tool (CRNAT) for individualized secondary prevention. Heart, Lung and Circulation, 24(5), 458-464 DOI: 10.1016/j.hlc.2015.01.001.

Sumner, J., Harrison , A., & Doherty, P. (2017, May). The effectiveness of modern cardiac rehabilitation: A systematic review of recent observational studies in non-attenders versus attenders. PLoS One, 12(5), e0177658 DOI: 10.1371/journal.pone.0177658.